Kidney Stones

Overview of Kidney Stones in ADPKD

The prevalencia of cálculos renales in ADPKD pacientes is approximately 15-20%, significantly higher than in the genral population (about 5-10%). Contributing factors include altered urinario tract anatomy due to quiste compression, urinario stasis, and metabolic abnormalities (such as low citrate excreción and hyperuricemia). Kidney stones can cause pain, hematuria, obstruction, and infection, all of which can worsen riñón damage — making prevención and management essential.

Stone Types

• Uric acid stones: Relatively common in ADPKD pacientes, associated with uric acid metabolism abnormalities and acidic orina
• Calcium oxalate stones: Also fairly common, related to dietary and metabolic factors
• Infection stones (struvite): Patients with recurrent infección del tracto urinarios may develop magnesium ammonium phosphate stones
• Mixed stones: Some pacientes have stones composed of multiple materials

Common Symptoms

• Flank or dolor de espalda: May be dull ache or severe colic; pain may suddenly worsen when a stone moves
• Hematuria (blood in orina): Visible or microscopic blood in the orina, caused by the stone irritating the urinario tract lining
• Obstruction: A stone blocking the urinario tract can cause difficulty urinating or reduced orina output
• Associated infection: May present with fiebre, chills, and frequent, urgent, or painful urination
• No síntomas: Some small stones cause no noticeable síntomas and are discovered incidentally during imaging

Diagnostic Methods

• Non-contrast CT scan: The primary method for diagnosing cálculos renales; shows stone size, location, and degree of obstruction
• Ultrasound: Radiation-free, useful for initial tamizaje, but has limited sensitivity for small stones
• Abdominal X-ray: Can detect radiopaque stones, but will miss radiolucent stones such as uric acid stones
• Urinalysis: Evaluates hematuria and signs of infection
• Stone composition analysis: Passed or surgically retrieved stones can be analyzed to guide prevención
• Metabolic evaluation: Blood uric acid, 24-hour orina biochemistry, and other tests to assess underlying causes

Management Principles

Management of cálculos renales should be evaluated by a urólogo, with decisions based on stone size, location, síntomas, and función renal. This page does not provide specific tratamiento plans — do not attempt to pass stones on your own.

• Conservative observation: Small, asíntomaatic stones may be monitored with seguimiento, arranged by your doctor
• Medication-assisted passage: Some stones may be helped to pass with medicamento, requiring a doctor's prescription
• Extracorporeal shock wave lithotripsy (ESWL): Suitable for certain qualifying stones, evaluated by a urólogo
• Minimally invasive surgery: Such as ureteroscopic lithotripsy or percutaneous nephrolithotomy; quiste impact must be assessed
• Associated infection: Infection must be controlled before stone tratamiento; urgent situations require immediate intervention

Prevention Measures

Adequate Hydration

• Aim for 2-3 liters of ingesta de líquidos per day to maintain adequate orina output (at least 2 liters per day)
• Distribute ingesta de líquidos evenly throughout the day, including moderate amounts at night
• Patients with declining función renal should follow their doctor's guidance on ingesta de líquidos to avoid excess

Uric Acid Control

• Patients with high uric acid levels should have their doctor assess whether uric acid-lowering tratamiento is needed
• Reduce high-porina foods: órgano meats, seafood, rich meat broths
• Limit sugary drinks, especially those high in fructose

Low-Sodium Diet

• Aim for less than 5g of salt per day; reduce processed foods
• A low-sodio diet helps reduce urinario calcio excreción, lowering the riesgo of calcio oxalate stones

Other Prevention

• Adequate calcio intake: Do not blindly restrict calcio — dietary calcio helps bind oxalate in the gut
• Reduce high-oxalate foods: Such as spinach, strong tea, and chocolate — consume in moderation
• Citrate supplementation: Patients with low citrate excreción may be evaluated by their doctor for supplementation
• Regular seguimiento: Patients with a history of stones should have regular imaging seguimiento at intervals determined by their doctor

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